Needy 'face social care struggle'

Elderly and disabled people in England are increasingly being denied social services, a report says. The Commission for Social Care Inspection said councils were tightening their criteria which determines who is eligible for care. The watchdog said the situation meant there were 281,000 people in need of help receiving none while another 450,000 suffered shortfalls in care.

Ministers have ordered a fundamental review of the rules on eligibility.

Councils have been setting a higher threshold for care in recent years as there is increasing demand for social care driven by the ageing population. Pressure on budgets has also been felt - partly from the fall-out from the NHS cost cutting in recent years.

The watchdog said two thirds of the 150 councils in England only provided services to individuals with need classed as substantial or critical in 2006-7. This included everything from help getting up to assistance feeding, although the watchdog pointed out there ware huge variations in how these are defined from area to area.

This was up from just over half a year ago and the watchdog warned the trend is expected to continue and likely to have hit nearly three quarters by now. The report said one of the consequences of this was that fewer people were receiving home care support in 2006 - 358,000 - than in 1997 - 479,000 - despite the ageing population.

But it also pointed out that those who were receiving care were getting a better standard of service. Social care ratings have been increasing for the last five years and eight in 10 councils were now classed as good or excellent.

Commission chairman Dame Denise Platt said: "There is a sharp divide between those in full care and those that fall outside." She said life for those who were not getting enough care was a "tough" and called on councils to do more to help direct people towards services even if the state was not paying for it.

As well as the 2m people receiving social care, there are hundreds of thousands who are cared for by friends or family or who pay for help privately - in England personal care is means-tested, unlike Scotland where it is provided free.

Paul Cann, director of policy at Help the Aged, said: "The social care system is at breaking point. Overstretched and underfunded - the report demonstrates that the gap between need and provision is rapidly turning into a gulf."

John Ransford, deputy head of the Local Government Association, said councils wanted to provide care, but did not have enough money. "We have been saying very strongly that in a very tight financial settlement, we have to use those resources as effectively as possible and if you want more services, we need more resources."

But social care minister Ivan Lewis said: "It's not acceptable. That's why today, I'm announcing a fundamental review of the system which determines who gets care."

He said councils should be looking to address moderate need before it became critical. It comes as the government is preparing to draw up a green paper later this year to reform social care. Many experts have called for a system of co-funding whereby the state guarantees a set level of care and then matches anything extra an individual is willing to contribute.